Inpatient Clinical Pathway for Adolescents
with Suspected Substance Withdrawal
- Related Pathways
Confirm Diagnosis of Substance Use Disorder (SUD)
- Toxicology, Other Laboratory Studies as Indicated
- Consult:
- Adolescent Medicine
- Poison Control Center
- Behavioral Health, Social Work
Withdrawal
Assessment tools, treatment of symptoms by substanceContinue monitoring, supportive care for all patients
- Signs/Symptoms of Withdrawal from Other Commonly Misused Substances
- Medetomidine is a frequent adulterant in local drug supply
- Withdrawal can present as altered mental status, hypertension, tachycardia, uncontrolled nausea/vomiting
CIWA-Ar
Clinical Institute Withdrawal Assessment for Alcohol Scale
Clinical Institute Withdrawal Assessment for Alcohol Scale
COWS
Clinical Opiate Withdrawal Scale
Clinical Opiate Withdrawal Scale
- Pharmacologic Management of Alcohol, Benzodiazepines Withdrawal Symptoms with lorazepam
- Consider Adjunctive Medications for alcohol/benzodiazepines withdrawal symptoms
- Pharmacologic Management of Opioid Withdrawal Symptoms
- Consider Adjunctive Medications for opioid withdrawal symptoms
Continue CIWA-AR as indicated
Vitamin Supplementation for Alcohol Withdrawal
Benzodiazepine Taper
Continuous COWS, as indicated
Discharge Criteria
- Medical follow-up
- Provide Bridge to Outpatient Treatment
- SUD treatment scheduled
- SUD Care Options
- Outpatient SUD Care
- Voluntary or court-ordered
- Higher Levels of Care (SUD)
- Voluntary or court-ordered
- Inpatient
- Intensive outpatient/IOP
- Partial hospitalization
- Residential